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跨性别者获得医疗护理的障碍与差距:一项聚焦于希腊的TRANSCARE范围综述

Βarriers and Gaps to Medical Care for Transgender Individuals: A TRANSCARE Scoping Review with a Focus on Greece.

作者信息

Anastasaki Marilena, Angelaki Agapi, Paganis Philippos, Christidi Elena Olga, Papathanasiou Nancy, Stoupa Eleni Panagiota, Karamagioli Evika, Pikoulis Emmanouil, Lionis Christos

机构信息

Clinic of Social and Family Medicine, School of Medicine, University of Crete, 710 03 Heraklion, Greece.

Orlando LGBT+, 11527 Athens, Greece.

出版信息

Healthcare (Basel). 2024 Mar 13;12(6):647. doi: 10.3390/healthcare12060647.

Abstract

Trans people face substantial barriers to care worldwide. In Greece, limited evidence regarding trans health and actions to improve accessibility in healthcare services is available. This study aims to identify barriers to care for transgender populations in order to discuss the potential gaps in healthcare providers' training in this direction. A scoping review was conducted in PubMed. Study eligibility criteria included: (a) reporting on at least one barrier to care for trans individuals or at least one educational need for healthcare providers; (b) free full text availability; and (c) publishing from 2015 and afterwards. Discrepancies in study inclusion were discussed between the research team until consensus was reached. Out of 560 identified references, 69 were included in this study, with only three reporting empirical research from Greece. Several individual-, interpersonal-, and institutional-level barriers to healthcare for trans individuals were identified. These included discriminatory treatment by healthcare providers, a lack of knowledgeable providers trained on trans-specific healthcare issues, lack of trusted and safe healthcare environments, health coverage-related issues, and healthcare systems that do not take into account particular transgender health issues during care provision. Improving access to care for transgender people is a multidimensional issue that should be addressed at the societal, healthcare, and research levels. Actions for future professional education initiatives should focus on respecting transgender identity, protecting confidentiality, creating trusted provider-patient relationships, and providing sufficient competency on trans-specific healthcare issues.

摘要

在全球范围内,跨性别者在获得医疗护理方面面临重大障碍。在希腊,关于跨性别健康以及改善医疗服务可及性的行动的证据有限。本研究旨在确定跨性别群体获得护理的障碍,以便讨论医疗服务提供者在这方面培训可能存在的差距。在PubMed上进行了一项范围综述。研究纳入标准包括:(a) 报告至少一项跨性别者获得护理的障碍或医疗服务提供者至少一项教育需求;(b) 可免费获取全文;(c) 2015年及之后发表。研究团队讨论了研究纳入方面的差异,直至达成共识。在560篇识别出的参考文献中,本研究纳入了69篇,其中只有3篇报告了来自希腊的实证研究。确定了跨性别者在医疗保健方面的几个个人、人际和机构层面的障碍。这些障碍包括医疗服务提供者的歧视性待遇、缺乏接受过跨性别特定医疗问题培训的知识渊博的提供者、缺乏值得信赖和安全的医疗环境、与医保覆盖相关的问题,以及在提供护理时不考虑特定跨性别健康问题的医疗系统。改善跨性别者获得护理的机会是一个多层面问题,应在社会、医疗和研究层面加以解决。未来专业教育倡议的行动应侧重于尊重跨性别身份、保护隐私、建立值得信赖的医患关系,以及在跨性别特定医疗问题上提供足够的能力培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b583/10970254/ad03f721542e/healthcare-12-00647-g001.jpg

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